老年人胆囊结石合并胆总管结石术式选择探讨（附60例报告）

doi:10.7504/CJPS.ISSN1005-2208.2015.04.27

摘要/Abstract

摘要：

目的探讨腹腔镜胆囊切除（LC）联合胆总管切开取石术（LCBDE）与LC联合内镜下乳头括约肌切开取石术（EST）治疗老年人胆囊结石合并胆总管结石的疗效。方法回顾性分析2012年1月到2013年5月中国医科大学附属盛京医院普通外科收治的60例老年胆囊结石合并胆总管结石的临床资料。LCBDE组31例，EST组29例。结果 LCBDE组和EST组的住院时间、手术中转率及轻型并发症发生率差异均无统计学意义。LCBDE组重型并发症发生率（0 vs. 6.9%，P<0.05）和住院费用（30 063.9±9127.9）元vs.（43 858.3±10 142.6）元，P= 0.001）显著低于EST组。结论在老年人胆囊结石合并胆总管结石病人治疗中，LC联合LCBDE较联合EST同样安全有效，且有重型并发症发生率和住院费用低的优势，条件允许时，推荐首选LC联合LCBDE术式。

关键词: 胆囊结石, 胆总管结石, 内镜下乳头括约肌切开取石术, 腹腔镜胆总管切开取石术, 老年人

Abstract:

Comparison of operative methods for older patients with concomitant cholelithiasis and choledocholithiasis: A report of 60 patients WANG Zhong-kui, ZHAO Hai-ying, LIU Jin-gang, et al. Department of General Surgery, Affiliated Shengjing Hospital, China Medical University，Shenyang110004, China
Corresponding author：ZHAO Hai-ying, E-mail：zhaohy1@sj-hospital.org
Abstract Objective To compare the therapeutic effects of laparoscopic cholecystectomy（LC）plus laparoscopic common bile duct exploration (LCBDE) and LC plus endoscopic sphincterotomy (EST) for older patients with concomitant cholelithiasis and choledocholithiasis. Methods The clinical data of 60 older patients with concomitant gallstones and common bile duct stones admitted from January 2012 to May 2013 in Department of General Surgery, Affiliated Shengjing Hospital, China Medical University were analyzed retrospectively. Among them, 31 patients were in the LCBDE group, and 29 patients in the EST group. Results The total length of hospital stay,the rates of conversion to operation and the morbidity of mild complications had no obvious difference. The morbidity of severe complications (0 vs.6.9%, P<0.05) and hospitalization expenses [(30 063.9±9127.9) yuan RMB vs.(43 858.3±10 142.6) yuan RMB, P=0.001)] of LCBDE group was significantly lower than those of the EST group. Conclusion For older patients with concomitant cholelithiasis and choledocholithiasis, LC plus LCBDE is safe and effective, compared with LC plus EST, and has a lower morbidity of severe complications and hospitalization expense. LC plus LCBDE is the first choice when without contraindication.

Key words: cholecystolithiasis, choledocholithiasis, endoscopic sphincterotomy(EST), laparoscopic common bile duct exploration(LCBDE), the older

王中魁，赵海鹰，刘金钢，张春菊，吴金龙. 老年人胆囊结石合并胆总管结石术式选择探讨（附60例报告）[J]. 中国实用外科杂志, DOI: 10.7504/CJPS.ISSN1005-2208.2015.04.27.

[1]	朱杰高, 吴鸿伟, 刘坤, 汪栋, 刘军, 郭伟, 张忠涛. 腹腔镜胆囊切除术中经胆囊管胆总管探查诊治胆总管结石价值分析[J]. 中国实用外科杂志, 2022, 42(04): 409-411.
[2]	王向，张永杰. 对保胆取石历史和现状再认知[J]. 中国实用外科杂志, 2021, 41(06): 662-667.
[3]	王春友. 合并胆囊结石急性胰腺炎病因辨析[J]. 中国实用外科杂志, 2020, 40(11): 1247-1250.
[4]	王仕琛1，田开亮1，赵成功1，张明金1，任建安2. 胆囊十二指肠横结肠多发内瘘合并胆石性肠梗阻1例报告[J]. 中国实用外科杂志, 2020, 40(05): 599-600.
[5]	吴波1，彭慈军1，冯赞杰2，李阳1，耿新1，高伟东1. 直径≥10 mm胆总管结石手术治疗研究进展[J]. 中国实用外科杂志, 2019, 39(10): 1107-1110.
[6]	胡杏池，孙长华，刘根祥. 腹腔镜经胆囊管取石和胆总管切开取石治疗胆囊结石合并胆总管结石临床比较研究[J]. 中国实用外科杂志, 2019, 39(02): 178-180.
[7]	高振华，王军宏，钱宏亮，吕鹏翔，赵佩玉，赵敏. 胆道镜治疗胆道残余结石36例临床研究[J]. 中国实用外科杂志, 2018, 38(12): 1428-1429.
[8]	张航1，2，刘丹青2，肖乐2，张炳印2，刘卫辉1，2. ERCP联合SpyGlass系统治疗高危胆囊结石合并继发胆总管结石可行性研究[J]. 中国实用外科杂志, 2018, 38(11): 1310-1313.
[9]	汤朝晖，靳龙洋，魏妙艳，全志伟. 胆道良性疾病诊治中的若干争议及共识[J]. 中国实用外科杂志, 2018, 38(02): 142-145.
[10]	范雄伟1，2，杨海涛1，郭伟2，张忠涛2. 腹腔镜经胆囊管胆道探查取石术32例报告[J]. 中国实用外科杂志, 2018, 38(02): 224-226.
[11]	楼健颖，陈伟，王冀，梁廷波. 一期扩张法经皮经肝胆道镜在肝内外胆管结石治疗中的应用（附35例报告）[J]. 中国实用外科杂志, 2017, 37(08): 892-895.
[12]	赵海鹰，刘金钢. 从过度和不足角度看无症状性胆囊结石与胆囊息肉的规范化治疗[J]. 中国实用外科杂志, 2016, 36(10): 1053-1057.
[13]	陈伟，梁力建. 胆囊功能的再认识[J]. 中国实用外科杂志, 2015, 35(09): 926-928.
[14]	郭伟，张忠涛. 保胆取石术尚存争议的问题[J]. 中国实用外科杂志, 2015, 35(09): 923-925.
[15]	商昌珍，陈亚进. 胆囊结石合并肝外胆管结石的诊治策略[J]. 中国实用外科杂志, 2015, 35(09): 951-954.

老年人胆囊结石合并胆总管结石术式选择探讨（附60例报告）

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics